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常规根治术、门静脉重建和肝动脉重建治疗肝门部胆管癌的安全性及近期疗效比较

Comparison of Safety and Short-term Efficacy Among Conventional Radical Surgery, Portal Vein Reconstruction and Hepatic Artery Reconstruction on Hilar Cholangiocarcinoma

  • 摘要:
    目的 比较常规根治术、门静脉重建和肝动脉重建三种手术方式治疗肝门部胆管癌的安全性及近期疗效。
    方法 选取108例行胆管癌根治术的肝门部胆管癌患者,根据不同手术方式分为三组:常规根治术组(A组)28例,门静脉重建术组(B组)48例和肝动脉重建术组(C组)32例。比较三组患者围术期的相关指标、术后并发症及术后1年生存率、淋巴结转移等情况。
    结果 C组手术时间、术中出血量、住院时间及住院费用均高于A组和B组(均P < 0.05)。三组患者术后并发症发生率差异无统计学意义(χ2=0.110, P > 0.05)。三组患者淋巴结转移率及术后1年生存率差异均无统计学意义(均P > 0.05)。
    结论 与常规根治术和门静脉重建术比较,肝动脉重建患者近期生存率无差异,可提高根治性手术切除率;但其手术时间和住院时间较长、术中出血量较高、住院花费多。

     

    Abstract:
    Objective To compare the safety and short-term efficacy among conventional radical surgery, portal vein reconstruction and hepatic artery reconstruction on hilar cholangiocarcinoma.
    Methods A total of 108 patients with hilar cholangiocarcinoma who underwent radical surgery were divided into three groups: group A (n=28, conventional radical surgery), group B (n=48, portal vein reconstruction) and group C (n=32, hepatic artery reconstruction). Perioperative-related indicators, postoperative complications, 1-year survival rate and lymph node metastasis among the three groups were compared.
    Results The operation time, intraoperative blood loss, hospitalization time and hospitalization cost of group C were higher than those of group A and group B (all P < 0.05). There was no significant difference in the incidence of complications, lymph node metastasis rate or 1-year survival rate among three groups (all P < 0.05).
    Conclusion Compare with conventional radical surgery and portal vein reconstruction, the short-term survival rate of patients treated with hepatic artery reconstruction is higher and the radical surgery resection rate could be improved, but with longer, operation time and hospitalization time, more intraoperative blood loss, and hospitalization cost.

     

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